Questões de Social Insurance

1. TDI-PEARSONVUE — 2026

Medicaid is funded by:

1. A)Federal government only
2. B)State governments only
3. C)Beneficiary premiums exclusively
4. D)Both federal and state governments

Gabarito: D

Medicaid is a joint federal-state program. The federal government matches state spending according to a formula based on per capita income. States administer their programs within federal guidelines.

2. TDI-PEARSONVUE — 2026

Martha enrolls in a Medicare Advantage plan. Which Medicare part is she utilizing?

1. A)Part A
2. B)Part B
3. C)Part C
4. D)Part D

Gabarito: C

Medicare Part C refers to Medicare Advantage plans, which are private insurance alternatives that provide all Part A and Part B benefits, and often include Part D coverage. Beneficiaries must have both Parts A and B to enroll.

3. TDI-PEARSONVUE — 2026

A beneficiary enrolled in a Medicare Advantage Plan (Part C) needs prescription drug coverage. How is this typically obtained?

1. A)By enrolling in a separate stand-alone Part D plan while keeping the Part C plan
2. B)Part C plans that include drug coverage (MA-PD plans) provide integrated benefits
3. C)By disenrolling from Part C and returning to Original Medicare with Part D
4. D)Prescription coverage is automatically included in all Part C plans

Gabarito: B

Many Medicare Advantage plans offer integrated prescription drug coverage (MA-PD plans). Beneficiaries cannot have both a Part C plan and a separate Part D plan simultaneously; they must choose a Part C plan with drug coverage or one without.

4. TDI-PEARSONVUE — 2026

An individual qualifies for both Medicare and Medicaid coverage. What term describes this dual eligibility status?

1. A)Medi-Medi beneficiary
2. B)Dual eligible
3. C)Cross-qualified recipient
4. D)Federal-state participant

Gabarito: B

Individuals who qualify for both Medicare and Medicaid are referred to as 'dual eligible' beneficiaries. Medicaid may help pay Medicare premiums, deductibles, and coinsurance for these individuals.

5. TDI-PEARSONVUE — 2026

Medicaid eligibility is primarily determined by which entity?

1. A)The federal Centers for Medicare & Medicaid Services using uniform national criteria
2. B)Individual states within federal guidelines
3. C)The Social Security Administration based on work credits
4. D)County health departments in each jurisdiction

Gabarito: B

Medicaid is a joint federal-state program. While the federal government sets broad guidelines, each state administers its own Medicaid program and determines specific eligibility criteria within those parameters.

6. TDI-PEARSONVUE — 2026

A Medicare beneficiary visits her primary care physician for a routine annual wellness exam. Under which Medicare part is this service covered?

1. A)Part A, as a preventive hospital service
2. B)Part B, as a physician and preventive service
3. C)Part C, through a Medicare Advantage plan only
4. D)Part D, as part of comprehensive drug coverage

Gabarito: B

Medicare Part B covers physician services, outpatient care, and preventive services including annual wellness visits. Part A covers inpatient hospital care, Part C is an alternative delivery system, and Part D covers prescriptions.